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Colon Cancer - Important Screening Procedures

Dear Dr. Dave & Dr. Dee,

I just turned 50 years old, and in good health with no family history of any cancer, yet my officemates keep razzing me to get a colonoscopy. One of my coworkers had a colonoscopy last year, and from the description of it, I would really rather put this off, if there is a better alternative. What about a virtual colonoscopy?



Dear Reluctant,

Colon cancer is the second leading cause of cancer related deaths after lung cancer. The good news is that colon cancer is preventable and curable if detected early. The most common risk factor is being age 50 or older because over 90% of the colon cancers are found in this age group. Also, 70% of patients with colon cancer did not have a family history of colon cancer.

A "virtual" colonoscopy or computed tomography (CT) of the colon is only recommended for people who are average risk, but not those at high risk for colon cancer. A colonoscopy is still the gold standard for early detection (American Cancer Society, 2008).

In brief below are the American Cancer Society Colon and Rectal Screening Guidelines (2008): Beginning at age 50, both men and women at average risk for developing colorectal cancer should use one of the screening tests below.

Tests that find polyps and cancer

1. flexible sigmoidoscopy every 5 years*

2. colonoscopy every 10 years

3. double contrast barium enema every 5 years*

4. CT colonography (virtual colonoscopy) every 5 years*

Tests that mainly find cancer

1. fecal occult blood test (FOBT) every year*,**

2. fecal immunochemical test (FIT) every year*,**

3. stool DNA test (sDNA), interval uncertain*

*Colonoscopy should be done if test results are positive. **For FOBT or FIT used as a screening test, the take-home multiple sample method should be used. A FOBT or FIT done during a digital rectal exam in the doctor's office is not adequate for screening.

People should start colorectal cancer screening earlier and/or being screened more often if they have a personal or strong family history of colorectal cancer, adenomatous polyps, or chronic inflammatory bowel disease.

For more information, see